HERE you will find an application form adapted for use in this ...

The Steam Car Club
of Great Britain
Application for Membership
~ American Form ~
Please print your name and address clearly:
First Name Mr / Ms…………………………………Last Name (Surname).........................................................................
Address: [First line]...............................................................................................................................................................................
[Second line]........................................................................................................................................................................
[Third line]............................................................................................................................................................................
City ………………………………………………..……State ………….…Zip…………….………Country....................................
email....................................................................................................................................................................................................................
Telephone(s)..................................................................................................................................................................................................
Please give details of your interests or of cars owned:
Data Protection Act The information given on this form will be stored electronically. The club policy is to
maintain a record of the details you provide. No details will be given to a third party. Should any club member
wish to contact another club member, the following system will apply: Contact a committee member who will,
on your instructions give your details to the person you wish to contact, giving them the opportunity to respond
direct. Please indicate your wishes by striking out that which does not apply:
Address: approve / decline Telephone: approve / decline email: approve / decline
Signature...................................................................................................................... Date........................................................................
The current subscription is £25 (£26 by PayPal) or US $40, valid for one year. Please do not
use US$ for PayPal payments. Methods of payment are detailed on the next page.
Please send this form, indicating the method of payment, to the American Representative:
Thomas Dawson, SCCGB Committee, 48 Holman Street, Laconia, NH 03246-3016.
The Steam Car Club of Great Britain
www.steamcar.net

Methods of payment – circle the method (1 to 5) you have chosen
Reference: In each case you need to quote a reference so that we know who has sent the payment. The
reference should be: Initial + Surname + NEW. Examples:
John P Weinstock – ref: J WEINSTOCK NEW
or Marcel Descartes – ref: M DESCARTES NEW
1 By PayPal
(i) Open your PayPal account
(ii) Click the “Send Money” tab
(iii) Enter sccmemsec@btinternet.com in the “To” box
(iv) Enter 26.00 in the “Amount” box
(v) Select GBP – British Pounds from the drop-down list
(vi) Click “Purchase” then select “Services” then click “Continue”
(vii) Quote the reference above in the “Message” box at the bottom
(viii) Click “Send Money” PayPal will make the currency conversion.
2 By Dollar Check
Send a check for $40 drawn on a US bank, made payable to The Steam Car Club of Great Britain, to
Thomas Dawson at the address at the foot of the previous page. I will forward to the Membership
Secretary and Treasurer Christopher Busk.
3 By Sterling Credit Transfer
Make a transfer of £25 to:
Lloyds TSB account: The Steam Car Club of Great Britain
Sort Code: 30 - 93 - 94
Account No.: 00031906 (eight digits)
Please quote the reference above
Please ensure transfers cover £25.00 plus any commission charged.
4 By Sterling Cheque
Send a cheque for £25 drawn on a UK bank, made payable to The Steam Car Club of Great Britain, to
me at the address at the foot of the previous page.
5 By Sterling Bank Transfer
Make a transfer of £25 to:
Lloyds TSB account: The Steam Car Club of Great Britain
BIC:
LOYDGB21218
IBAN: GB96 LOYD 3093 9400 0319 06
Please quote the reference above
Please ensure transfers cover £25.00 plus any commission charged.
The Steam Car Club of Great Britain
www.steamcar.net